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dancerjodiWe didn't hit one of our Inpatient Days targets for 2004, so we've been pulling together information for an appeal. At a high level, we have a ton of $ on the line if we don't hit this target. Without getting into the details, we think we've been pretty good about managing inpatient utilization locally - we're getting killed on our admits that go into Boston. We've sent less people there, but their length of stay has gone up exponentially (and that's something we have no control over). Patient severity doesn't account for it - casemix adjusted LOS has increased almost 2 days!
As such, work has been nuts over the last couple of weeks. If our appeal is accepted by Partners we have a chance to earn some or all of our forfeited $ back. We think we may have found something, kind of an ah ha moment! It seems that THP is paying for a lot of days they shouldn't have at our own hospital. Paid days = days counted in this measure. We just may have something to save our butt!
Ah the joys (not) of a Managed Care, pay for performance world. And now back to the crazy grind! :)
As such, work has been nuts over the last couple of weeks. If our appeal is accepted by Partners we have a chance to earn some or all of our forfeited $ back. We think we may have found something, kind of an ah ha moment! It seems that THP is paying for a lot of days they shouldn't have at our own hospital. Paid days = days counted in this measure. We just may have something to save our butt!
Ah the joys (not) of a Managed Care, pay for performance world. And now back to the crazy grind! :)
